Birth Story of Pilar and Sam

It was during Pilar's 34th week that we first met for an informational visit about what a doula is and whether I might be the right doula for them. During this visit, they voiced their reasons for thinking about wanting a doula present. Sam shared his concerns about hearing so many other birth stories and hearing so much advice from friends and family, not to mention judgments being made on their desire for natural childbirth. They let me know they wanted a doula for non-judgmental support and as an advocate for their vision of labor and birth. At the same time it was very important to them that Sam was Pilar's main support person.

During our prenatal visits together we practiced positions for labor, went over their birth plan, and discussed tips for breastfeeding, and what to expect in terms of newborn care. During Pilar's 38th week, her doctor let her know she was one centimeter dilated. This made Sam and Pilar feel very excited and anticipatory about when labor would begin. Two weeks past though, and know there feelings were a little beyond anxious and just really wondering if it was going to happen.

And it did. At 7am, during Pilar's 40th week of pregnancy, Sam called me to let me know that Pilar had been awake since 4am. She had been feeling light cramps. She didn't think it was labor because they were not too painful, but she was too uncomfortable to sleep. I asked how often and for how far apart she was feeling these "cramps". Sam let me know they were lasting 40-45 seconds and coming every 2-3 minutes. I encouraged them to call their provider even thought hey weren't sure she was actually in labor. They had had an appointment to see their doctor any way that day. Once the doctor spoke with them and found out about Pilar's cramps, she suggested they come in one hour earlier, at 10am.

We kept in close phone contact from that 7am call through the time they went to their doctor's office. It was when Pilar was getting into the car to go, that her cramping began to be a bit more , but still tolerable. When she arrived at the doctor's office, she was given a vaginal exam and found to be 7 centimeter's dilated! Same and Pilar really didn't expect such quick progress. They called and let me know right away that they were on their way to the hospital and could I meet them there. We all met there at about 10:45am. Pilar's labor pains reached their highest intensity upon arriving. She worked through the pains by walking constantly up and down a long corridor, as we waited for a room.

Pilar was GBS (Strep B) positive. Although her membranes (bag of waters) had not ruptured yet, she was hooked up to an IV and also to an electronic fetal monitor (note: upon entering most hospitals, they will want a continuous fetal monitor reading for approximately 20 minutes, before they will let you be more mobile and not attached). She was hooked up to the IV because she was progressing so quickly, they wanted to be sure she would get a dose of antibiotics in her as soon as her membranes ruptured.

In Pilar and Sam's birth plan, they had expected to be using the birth ball (which they had practiced so many positions in), and some other tricks they had picked up to help cope with the pain of contractions. However, at this point the thing that really seemed to be working for Pilar was to rest in between contractions and to have quiet and focus inward for each contraction. Having Sam by her side was incredibly important. Sam and I made sure she was drinking right before and right after each contraction and that she was as comfortable as she could be. They had not anticipated Pilar's desire to not move. In fact, they were prepared for a lot more activity. They also had not anticipated such quick progress. They were clearly able to consciously re-adjust.

Pilar began feeling a desire to push and a lot of pressure in her rectum at about 11:45am. She was checked by the doctor on staff and found to be almost fully dilated with just a little anterior lip left. The nurses called Pilar's doctor and let her know to get to the hospital as quickly as possible. They let Pilar know she would be there very soon.

By 12pm, Pilar's doctor had arrived. She checked Pilar and let her know she was fully dilated. Her membranes had not ruptured yet and the doctor told Pilar she would rupture them and then Pilar would be ready to begin pushing. The doctor left the room and Pilar looked a bit puzzled. She asked me why she needed to get her membranes ruptured and voiced being unsure of whether she wanted this procedure to take place. Sam was also unsure. I encouraged them to ask their doctor questions about the necessity of the procedure and to help clarify her reasons for wanting to do it. Pilar and Sam did and then they were able to decide on whether they really wanted her membranes artificially ruptured or not. This happened quickly, but was so significant. Pilar and Sam were able to really own their labor experience and were determined to be actively involved. They realized they had choice.

Once Pilar was ready to push (approximately 12:10pm) she assumed the position that was most comfortable for her. She sat upright, grabbed the back of her thighs with her hands and curved her back forward, bringing her head to her chest. Her doctor would tell her to push, Sam would count to 10 (because Pilar had asked him to help guide her pushing) and I would softly remind her to try to relax the muscles in her face and focus all of her energy on pushing through her rectum. In between contractions, Pilar would lay back and rest. Sam or I would offer her water and/or ice chips and Sam would faithfully run his fingers through her hair, as she loves when he does this. He would also put cold wash clothes her her head, to help cool her off.

We continued this rhythm of pushing and resting for approximately 45 minutes and Keagan was born at 12:57pm, just 3 hours after Pilar actually realized she was in labor. Sam and Pilar were very satisfied with their labor and birth experience. They had the tools they needed for labor. In hindsight, Sam said, "We didn't get a chance to use all of the techniques we had learned for coping with contractions, but we felt so comfortable and secure because we had a strong supportive labor team and we had prepared ourselves for what we wanted, and also the many possibilities of what might happen. This made all the difference for us!!"